Improved survival in a rare cancer with chemotherapy

An interesting article has been published in the latest New England journal describing how the addition of a cisplatin to gemcitabine improved survival by two months in biliary tract cancer. Currently, there is no standard treatment for this rare disease, so a solid phase III trial (ABC-02) represents an important step forward for treatment.

Biliary tract cancers are tumours that develop in the gallbladder and bile ducts. Those that develop in the bile duct within the liver are known as cholangiocarcinomas. Approx. 6500 new cases of gallbladder carcinoma are diagnosed each year in the US. Interestingly, chronic inflammation appears to be a common aetiologic factor in the disease development. There has been a rise in incidence of the cancer in recent years, which may possibly be attributable to the association between liver disease and increasing hepatitis C virus infections.

Although there are no standards, gemcitabine has been the bedrock of palliation therapy for the disease based on the experience in pancreatic cancer. The earlier ABC-01 phase II trial suggested a benefit in adding a platinum to gemcitabine.

In the current ABC-02 phase III trial, the median overall survival with the combination was 11.7 months and 8.1 months in the gemcitabine alone group, a significant improvement of 3.6 months.

As a result, the combination of cisplatin and gemcitabine is likely to become the new standard of care for the treatment of biliary tract cancer. As we learn more about the science and biology underlying the disease, further improvements may be possible with the addition of targeted agents.

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I am the producer of the MD Anderson Cancer Center’s Cancer Newsline audio podcast series, and I thought you and your readers may be interested in our latest episode: Bile Duct Cancer – Rare but Numbers are Growinghttp://www.youtube.com/watch?v=bNBWUL2vIfc